Blog from Senior Program Officer Heather Torok on Visit to Cuba

(7.10.17)Last month we convened a meeting for 15 partners from Cleveland non-profit organizations. The organizations were mostly Federally Qualified Health Care Clinics (FQHCs) and Behavioral Health Care Organizations. In the midst of a changing and stressful policy environment, we wanted to hear from our grantee partners about how they were doing. We asked them how they were managing budgets, staff, boards, advocacy and of course clients. All echoed concern over uncertainty, the need for contingency plans and fear over dollars that might be lost.

Care is not simply health care. These organizations serve clients holistically. The patient-centered medical home model means looking at a variety of services including transportation, translation, linking to social services, mental health care, prevention and education. This model of care has grown and benefitted exponentially with the expansion of Medicaid. More people are insured, and they are getting care in advance of getting sick. Also, there are decreased visits to emergency rooms because people are visiting regular medical centers where they can build trust more consistently with a doctor.

That same week, my husband and I travelled to Cuba. On the heels of my meeting with partners in Cleveland and the Federal conversation around health care streaming through media channels, I found my trip ironic. Here I was in this beautiful country, where average earnings are about $30/month and infrastructure is so limited yet they have enviable public health statistics.

Cuba’s child mortality rate is on par with some of the world’s richest countries. World Bank reports six deaths for every 1,000 births (2015), and Cuba’s average life expectancy matches that in the US: 79.1 years. In 2014, Margaret Chan, Director-General of the World Health Organization (WHO) said “the world should follow the example of the island in this arena and replace the curative model, inefficient and more expensive, with a prevention-based system.”

Cuba has a system that prioritizes and pays for prevention. The US is moving in this direction. Medicaid expansion as well as creating and supporting models of care that promote prevention will get us there. In the long run it costs less and yields better results.